Literature suggests that aspects of social cognition, as well as neuropsychological difficulties play a key role in the development and maintenance of Post-Traumatic Stress Disorder (PTSD) symptoms in brain injury survivors. The present study aimed to explore the direct relationship between measures of neuropsychological function and social cognition, and psychological outcomes related to PTSD. A quantitative, cross-sectional, correlational design was employed, using correlational and multivariate regression methods of analysis. Forty-nine adult brain injury survivors were administered a range of measures of neuropsychological function (memory, executive function and attention); social cognition (Mentalization, emotion recognition, social judgment making and emotion-based decision-making) and Psychological outcomes related to PTSD (depression, anxiety, anger and PTSD symptoms). Significant relationships were found between measures of Mentalization, attention and memory, and symptoms relating to depression and PTSD. Selective visual attention and Mentalization were found to account for 37% of the relevant variance for depressive symptoms, while Mentalization and delayed memory recall accounted for 24% of the relevant variance for PTSD symptoms. Different measures of Mentalization showed unexpected correlation directions, which had significant implications for the role Mentalization might play in maintaining PTSD symptoms. The findings suggest an association between aspects of social cognition and neuropsychological functioning, and psychological outcomes related to PTSD. It is thought that impairments in these areas could play a role in maintaining these outcomes in Acquired Brain Injury survivors.

Cognitive complaints are common following an acquired brain injury and require careful assessment in order to guide treatment and care. There is a need for brief, comprehensive and psychometrically valid tests of cognitive function that can be used in neuro-rehabilitation services by a range of health professionals. The Short Parallel Assessments of Neuropsychological Status (SPANS) was purpose-designed to meet this need. The current study assessed the reliability, discriminative validity and factor structure of the SPANS. Participants were 61 people with an acquired brain injury, 35 people with a long-term neurological condition, and 122 healthy controls. Cronbach’s alphas were adequate to excellent for the clinical groups though poor for the healthy controls due to limited variance in the scores. Receiver operating characteristic curves showed that SPANS indices were significantly able to discriminate between people with a neurological condition and healthy controls as well as between left and right hemisphere damage. Exploratory factor analysis suggested the retention of 25 subtests representing three factors that largely followed the purported structure of the test: Memory and Learning, Language, and Visual-motor Performance. Limitations of the study, clinical/theoretical implications and research directions are considered. It is concluded that the SPANS is a reliable and valid tool for the assessment of cognitive function in people with an acquired brain injury, though further validation studies are required.

Diss. (sammanfattning) Linköping : Univ., 2001. / Härtill 4 uppsatser.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 6 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2006. / Härtill 4 uppsatser.

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2003. / Also held in print (251 leaves, 30 cm.) in North Shore Theses Collection (T 617.4810443083 JON).

Diss. Luleå : Luleå tekniska univ., 2007. / Härtill 4 uppsatser.

Made available in DSpace on 2015-07-22T20:49:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-12-31 / Objetivo: Verificar a inter-relação entre a memória operacional e a apraxia verbal e explorar quais os componentes desta memória estariam envolvidos na programação motora da fala. Métodos: Foram avaliados 22 sujeitos apráxicos e 22 controles. Foram aplicados um teste de compreensão e um protocolo para avaliar e classificar o grau da apraxia de fala. Para investigar a memória operacional dos indivíduos, foram aplicados o teste de span de dígitos na ordem direta e inversa, um teste de repetição de palavras curtas e longas, sendo que ambos investigam o funcionamento da alça fonoarticulatória e o Rey Auditory Verbal Learning Test, que investiga, além da alça fonoarticulatória, o buffer episódico. Resultados: Através da análise estatística realizada, algumas diferenças significantes foram encontradas. O desempenho dos apráxicos nos testes de memória, tanto no span de dígitos direto e inverso, quanto na repetição de palavras curtas e longas e no Rey Auditory Verbal Learning Test foi estatisticamente significante mais baixo que o desempenho dos controles. Também foi evidenciado que a performance entre os apráxicos em todos os testes de memória foi semelhante, independentemente do grau da apraxia. Conclusão: A partir dos resultados citados anteriormente, o estudo concluiu que os indivíduos com apraxia de fala apresentam um déficit na memória operacional e que este déficit está mais relacionado ao processo articulatório da alça fonoarticulatória. Além deste achado, pôde-se observar que o grau de comprometimento do déficit de memória operacional apresentado pelos apráxicos é independente do grau de apraxia de fala destes indivíduos. / To verify the interference of working memory in the apraxia of speech and explore which components of this memory would be involved in the motor planning of speech. Methods: There were assessed 22 apraxic subjects and 22 control subjects. There were administered a comprehension test and a protocol used to assess and classify the degree of apraxia of speech. To investigate working memory in the subjects, digit span forward and backward test, and a short-lenght and long-lenght word repetition test, both able to assess the phonoarticulatory loop, and the Rey Auditory Verbal Learning Test, which investigates both the phonoarticulatory loop and the episodic buffer, were administered. Results: The statistical analysis of the study showed some significant differences. The apraxic subjects performances in the memory tests, in the forward and backward digit span test, as well as in the short-lenght and long-length word repetition test, and in the Rey Auditory Verbal Learning Test was statistically significantly lower than the performance of the control group. It was also emphasized that the performance among the apraxic subjects in all of the memory tests was similar, independently on the degree of the apraxia. Conclusion: From the results mentioned earlier, the study concluded that subjects with apraxia of speech present a working memory deficit and that this deficit is more related to the articulatory process of the phonoarticulatory loop. Furthermore, a degree of compromise in the working memory deficit shown by the apraxic subjects is independent from the degree of apraxia of speech in these individuals. / TEDE / BV UNIFESP: Teses e dissertações

Traumatic brain injury is a substantial cause of disability worldwide; recovery is a long-term, intensive process. Patients with traumatic brain injury are admitted to inpatient rehabilitation with the goal of preventing disability and the need for long-term care as well as promoting patient independence. Acknowledging that traumatic brain injury also affects the family, much of the literature focuses on the well-being of families and their needs, bringing attention to family functioning, resilience, and psychosocial well-being. Recognizing the important role of families in health care, Canadian healthcare institutions espouse family-centred philosophy. Not to mention, the resulting impairments from traumatic brain injury and the complex nature of inpatient rehabilitation can also lead to the involvement of families in this process. However, we do not yet fully understand how families are involved in adult inpatient traumatic brain injury rehabilitation. Given the adoption of a family-centred philosophy as well as the potential benefits of family-centred care for patient and family outcomes, it is important to understand this involvement to guide the provision of family-centred health and rehabilitation services. This study is the first step in a program of research that is devoted to understanding family involvement in adult inpatient traumatic brain injury rehabilitation. I used an interpretive qualitative approach with a two-phased sequential design to elucidate how families were involved in the inpatient rehabilitation process. I conducted one-on-one semi-structured interviews with six patients with TBI, four family members, and 10 healthcare professionals followed by observations on the inpatient Acquired Brain Injury ward at a Canadian adult rehabilitation centre. In Phase 1 interviews, both the patients and family members described family involvement as family members being with and supporting the patients, informing other family members as well as the healthcare professionals and keeping themselves informed, helping the patients to make decisions, and participating in care and therapy. The healthcare professionals similarly described family members being with and supporting the patients; however, they conversely illustrated family members’ involvement as providing information to and receiving information from the healthcare professionals as well as making decisions when required or deemed necessary by them, and learning care and therapy. While the observation findings supported the patients’, family members’, and healthcare professionals’ perceptions that family members support the patients by being present and spending time with them, they highlighted the healthcare professional-led nature of the rehabilitation process in the inpatient setting in relation to information sharing, decision making, and care and therapy. They also illuminated the potential impact of the ward environment on family involvement. This study was the first to explore family involvement with this adult patient population in the inpatient rehabilitation setting from the perspectives of patients, family members, and healthcare professionals as well as through direct observation. It revealed that patients and family members had different understandings than healthcare professionals of the ways in which families were involved. Given the adoption of a family-centred philosophy, we need to understand how to operationalize it in this type of adult setting and close the gap between theory and practice.

Thesis (Ed.D.)--Boston University